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. 2017 May 16;12(5):e0177500.
doi: 10.1371/journal.pone.0177500. eCollection 2017.

Insulin resistance contributes more to the increased risk for diabetes development in subjects with low lipoprotein(a) level than insulin secretion

Eun-Jung Rhee  1 , Jung Hwan Cho  1 , Da Young Lee  1 , Hyemi Kwon  1 , Se Eun Park  1 , Cheol-Young Park  1 , Ki-Won Oh  1 , Sung-Woo Park  1 , Won-Young Lee  1
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Insulin resistance contributes more to the increased risk for diabetes development in subjects with low lipoprotein(a) level than insulin secretion

Eun-Jung Rhee et al. PLoS One. .

Abstract

Background: Recent studies suggest an association between Lipoprotein(a) [Lp(a)] and the development of diabetes mellitus. We analyzed the association between baseline Lp(a) levels and diabetes development after 4 years of follow-up, in a population of apparently healthy Korean subjects.

Methods: A total of 2,536 non-diabetic participants (mean age: 41 years, men: 92%) of a health checkup program were included in the study. Diabetes development was defined by fasting blood glucose ≥126 mg/dL, HbA1c ≥6.5%, and self-reported treatment of diabetes. Homeostasis model assessment (HOMA) indices were used to assess insulin resistance (IR) and insulin secretion (IS). Presence of IR and impaired IS was defined by being in the highest quartile of HOMA-IR and in the lowest quartile HOMA-IS.

Results: After four years, 3.4% of the participants developed diabetes. The odds ratio (OR) of developing diabetes was lowest in the 4th quartile group of baseline Lp(a) (0.323 [95% CI 0.153-0.685])with the 1st quartile group as the reference. The subjects with both IR & impaired IS plus baseline Lp(a)<50 mg/dL showed the higher OR for diabetes development compared with those without IR and normal IS as the reference (67.277 [20.218-223.871], and those with IR plus Lp(a)<50 mg/dL showed higher OR for diabetes than in those with impaired IS and Lp(a)<50 mg/dL (3.811 [1.938-7.495] vs. 3.452 [1.620-7.353]).

Conclusions: The subjects with low baseline Lp(a) level showed higher risk for development of diabetes compared with high baseline Lp(a) level, and this was prominent in those with IR than in those with impaired IS.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Comparison of the proportion of subjects who developed diabetes over four years according to the baseline insulin secretory function, insulin resistance, and Lp(a) levels.
IR depicts being in the highest quartile of HOMA-IR; no IR means being in the lower three quartiles of HOMA-IR. Impaired IS depicts being in the lowest quartile of HOMA-IS; normal IS means being in the higher three quartiles of HOMA-IS. IR, insulin resistance; HOMA, homeostasis model assessment; IS, insulin secretion
See this image and copyright information in PMC

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